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Can a meniscectomy cause osteoarthritis to become worse?

Q) In a letter to Arthritis Today a retired consultant surgeon stated that she'd had a meniscectomy 'which of course resulted in osteoarthritis of that knee'. I would like to know the reason for this. I had a menisectomy as part of an arthroscopic procedure three years ago, as I was already suffering from osteoarthritis of the knee. Despite extensive treatment the arthritis has now become, in the words of my consultant, 'end stage', and I shall be having a knee replacement later in the year. In light of the above-mentioned letter, I'm now wondering if this procedure caused the arthritis to become worse, or did the condition deteriorate over the passage of time (my general assumption).
Linda, Nuneaton (Summer 2011)

A) Good question. Some years ago it was found that having a menisectomy (removal of the knee menisci, or cartilages) predisposed that joint to osteoarthritis in later years. Not surprisingly, a tendency to develop osteoarthritis in other joints increased that risk. Now, that study was done when menisectomies were achieved by opening the knee joint and the procedure was much more extensive than today’s keyhole approach, so it may not now be the case that osteoarthritis is a certain consequence of this procedure. You do have to remember, of course, that the reason for the torn meniscus (cartilage) may also be the reason for the later development of osteoarthritis, that is injury to the knee. Nowadays, with the keyhole approach, many people with torn menisci are found to already have established osteoarthritis and the arthroscopy (and menisectomy) is just one stage on the way to having a knee replacement. One will follow the other but it may be many years in between the procedures.

This answer was provided by Dr Philip Helliwell for the Summer 2011 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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